A 70-year-old man was admitted to our hospital with dyspnea. Chest X-ray film revealed right pleural effusion. Chest CT showed right pleural effusion with slight pleural thickening and a patchy calcification-like lesion. Adenocarcinoma cells were detected in pleural effusion, but upper gastrointestinal endoscopy, barium enema examination and ultrasonography of the abdomen failed to show the primary lesion. We made a diagnosis of primary adenocarcinoma of the lung. Chemotherapy was performed after pleurodesis. However there was gradual increase of right pleural thickening and expansion of the calcification-like lesions. The patient died 16 months after his first visit. Pathological findings of the autopsy specimen revealed the tumor composed of an adenocarcinomatous component and an osteosarcomatous component. The final diagnosis was primary carcinosarcoma of the lung.
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